Individuals with cancer frequently require long-term central venous access to deliver chemotherapy, blood products, and other fluids. A rare, but potentially lethal complication associated with central venous catheterization is venous air embolism which occurs most commonly after damage or disconnection at the catheter hub. The Groshong (Bard Access Systems, UT) catheter is a device with a unique three-position valve at its distal tip which eliminates the need for routine heparin flushing and minimizes the risk of venous air embolism. This report describes for the first time a near fatal venous air embolism in a patient with an externally accessed Groshong catheter.